COVID-19 vaccine hesitancy cannot fully explain disparities in vaccination coverage across the contiguous United States

Hu, Songhua; Xiong, Chenfeng; Li, Qingchen; Wang, Zitong; Jiang, Yuan

doi:10.1016/j.vaccine.2022.07.051

Cited by 25 publications

(25 citation statements)

References 40 publications

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“…Studies in Italy show the relationship between difficulties in accessing and understanding vaccine information and lower health literacy among a cross-sectional survey of 3500 participants [23]. Most studies assessed self-reported vaccine hesitancy; according to Hu et al, in a study assessing vaccine hesitancy and vaccination prevalence across the US, there is a large discrepancy between self-reported vaccine hesitancy and actual vaccination coverage (2022) [24]. Due to the availability of completed administrative vaccination data from the Georgia Department of Public Health, we were able to directly measure heath literacy rates and compare them with actual vaccine compliance.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Health Literacy and COVID-19 Vaccination Prevalence during a Rapidly Evolving Pandemic and Infodemic

et al. 2022

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The gap between how health information is communicated and what people understand and can use to make informed health decisions is called health literacy. This gap was exacerbated by the rapidly changing and excessive volume of information, misinformation, and disinformation during the COVID-19 pandemic. People with lower health literacy may not have understood the importance of COVID-19 vaccination for themselves or for their communities. Our aim was to understand health literacy levels within Fulton County, Georgia, and their relationship to vaccine prevalence. Fulton county residents ages 18 and over (n = 425) completed an on-line Health Literacy Questionnaire. Individual, organizational, functional, interactive, and critical health literacy scales were created. Vaccination prevalence data were collected from the Georgia Vaccine Distribution Dashboard. All data were divided into one of three county areas. There were statistically significant variations in vaccine prevalence χ2(3) = 29.325, p < 0.001 among the three county areas. All levels of health literacy predicted overall county vaccination prevalence F (4,420) = 85.941, p < 0.001, There were significant differences in health literacy levels among two of the three county area pairs; the lowest resourced county area had the lowest vaccination prevalence and health literacy rates. This is the first example of relating direct health literacy measures across a major metropolitan US county with vaccine prevalence data.

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Section: Discussionmentioning

confidence: 99%

The Relationship between Health Literacy and COVID-19 Vaccination Prevalence during a Rapidly Evolving Pandemic and Infodemic

et al. 2022

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“…Numerous factors may have served as barriers to initial COVID-19 vaccination, including poverty, disabilities, psychosocial factors, 17 computer literacy, and inadequate transportation. In addition, previous studies support the hypothesis that access to care was an important determinant of COVID-19 vaccine uptake 18–23 . For instance, a county-level analysis found an association between higher primary care provider density and increased area-level COVID-19 vaccine uptake 21 .…”

mentioning

confidence: 61%

“…In addition, previous studies support the hypothesis that access to care was an important determinant of COVID-19 vaccine uptake. [18][19][20][21][22][23] For instance, a county-level analysis found an association between higher primary care provider density and increased area-level COVID-19 vaccine uptake. 21 A ZIP code-level analysis found correlations between access to care and booster uptake in Massachusetts.…”

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confidence: 99%

Health Care Access and COVID-19 Vaccination in the United States

De Guzman,

Thomas,

Wiwanto

et al. 2024

Medical Care

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Background: Although federal legislation made COVID-19 vaccines free, inequities in access to medical care may affect vaccine uptake. Objective: To assess whether health care access was associated with uptake and timeliness of COVID-19 vaccination in the United States. Design: A cross-sectional study. Setting: 2021 National Health Interview Survey (Q2-Q4). Subjects: In all, 21,532 adults aged≥18 were included in the study. Measures: Exposures included 4 metrics of health care access: health insurance, having an established place for medical care, having a physician visit within the past year, and medical care affordability. Outcomes included receipt of 1 or more COVID-19 vaccines and receipt of a first vaccine within 6 months of vaccine availability. We examined the association between each health care access metric and outcome using logistic regression, unadjusted and adjusted for demographic, geographic, and socioeconomic covariates. Results: In unadjusted analyses, each metric of health care access was associated with the uptake of COVID-19 vaccination and (among those vaccinated) early vaccination. In adjusted analyses, having health coverage (adjusted odds ratio [AOR] 1.60; 95% CI: 1.39, 1.84), a usual place of care (AOR 1.58; 95% CI: 1.42, 1.75), and a doctor visit within the past year (AOR 1.45, 95% CI: 1.31, 1.62) remained associated with higher rates of COVID-19 vaccination. Only having a usual place of care was associated with early vaccine uptake in adjusted analyses. Limitations: Receipt of COVID-19 vaccination was self-reported. Conclusions: Several metrics of health care access are associated with the uptake of COVID-19 vaccines. Policies that achieve universal coverage, and facilitate long-term relationships with trusted providers, may be an important component of pandemic responses.

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“… 6 While vaccine hesitancy has been a major obstacle of COVID-19 vaccine coverage, 7 a recent study found that vaccine hesitancy did not fully explain the disparities in COVID-19 vaccination coverage in the United States. 8 Against this backdrop we assessed the role of a critical psychosocial factor, social support, on COVID-19 vaccine uptake.…”

Section: Introductionmentioning

confidence: 99%